The enigma of cannabis use in spinal cord injury

Spinal Cord Series and Cases, 2018 · DOI: https://doi.org/10.1038/s41394-018-0098-z · Published: May 26, 2018

Spinal Cord Injury Pharmacology Pain Management

Simple Explanation

Cannabis use for medical purposes is a complex topic with conflicting data on its effectiveness and side effects, especially for spinal cord injury (SCI) patients. Around 25% of individuals with spinal cord injuries report using cannabis for therapeutic purposes, even in areas where it may be illegal. The effects of cannabis are multifaceted due to its complex composition, including cannabinoids, terpenes, and flavonoids, which together create an 'entourage effect.'

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
The composition of cannabis sativa is complex, consisting of hundreds of cannabinoids as well as terpenes, ﬂavinoids, and phenoids.
2
Endogenous activation of the endocannabinoid system occurs after SCI, and some researches are considering the possible neuroprotective role that cannabis might possess.
3
Cannabis has a well recognized adverse event proﬁle, however unlike opioids, acetaminophen and alcohol, overdose on its own does not result in death.

Research Summary

Cannabis presents a complex challenge due to its intricate effects on the central nervous system. Practitioners hold differing opinions on cannabis, awaiting more definitive evidence regarding its therapeutic benefits. The classification of cannabis as strictly 'medicinal' or 'recreational' may be inappropriate; its use could be considered for general health and wellbeing.

Practical Implications

Personalized Cannabis Treatment

The 'entourage effect' suggests that cannabis treatment should be tailored to individual needs, considering the complex interactions of its components.

Further Research Needed

More robust, randomized research is needed to overcome the challenges of measuring symptom complexes like pain and spasticity in SCI patients.

Reclassification of Cannabis

The current 'medicinal' vs. 'recreational' classification of cannabis may be inappropriate and should be reconsidered for a 'health wellbeing' approach.

Study Limitations

1
Confusing interpretation of efficacy and adverse event data.
2
Lack of standardization and reproducibility of cannabis products.
3
Difficulty in conducting reputable randomized research in patients with symptom complexes.

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